超高场强磁共振血管成像对颈部动脉病变的诊断价值  

Magnetic resonance angiography with super high field in the diagnosis of carotid artery diseases

作　　者：徐亮[1] 冯德朝[1] 郑金勇[1] 丛培新[1] 孟祥水[1] 田家凯 李传福[1] 马祥兴[1] 

机构地区：[1]山东大学齐鲁医院影像中心,山东济南250012 [2]山东省胸科医院特检一科,山东济南250013

出　　处：《山东大学学报（医学版）》2007年第1期101-105,共5页Journal of Shandong University:Health Sciences

摘　　要：目的:分析三维对比增强MR血管成像(3D CEMRA)的临床应用价值。方法:对130例临床拟诊颈部动脉病变的患者行3D CEMRA检查,部分病例同时行TOF MRA成像、PC MRA成像和DSA检查。将颈部动脉分段后分别统计上述方法所发现的病变数目并进行χ2检验。将所有行3D CEMRA的患者按照不同的对比剂注射速度分为三组,将各组所得的图像进行对比,分析不同的对比剂注射速度对3D CEMRA成像效果的影响。结果:130例受检者中,18例未发现异常,占13.8%,112例有不同程度的病变,占86.2%。病变血管288段,其中粥样斑块形成者98段(占34.0%);动脉狭窄者75段(占26.0%);动脉闭塞者20段(占6.9%);动脉发育纤细者44段(占15.3%);动脉迂曲者46段(占16.0%);动脉发育变异者4段(占1.4%);动脉瘤1例(占0.3%)。93例3D CEMRA与TOF MRA比较,除颈外动脉以外均有显著性差异(P<0.05)。81例3D CEMRA与PC比较,各段动脉均有统计学差异(P<0.05)。8例3D CEMRA与DSA比较对动脉病变的检出率无统计学差异(P>0.05)。不同对比剂注射速度所得的图像进行对比,1 ml/s组与2 ml/s组之间及1 ml/s组与3 ml/s组之间均有统计学差异(P<0.05),而2 ml/s组和3 ml/s组之间无统计学差异(P>0.05)。结论:3D CEMRA诊断颈部动脉病变较TOF MRA及PC MRA准确,基本能代替DSA。不同的对比剂注射速度对CEMRA的成像效果有影像,要获得良好的CEMRA图像,必须选择合适的注射速度。Objective： To assess the value of 3D CEMRA in the diagnosis of arterial diseases in the neck. Methods： 3D CEMRA was performed in 130 patients who were suspected to have arterial diseases in the neck. Some patients also took TOF MRA, PC MRA and DSA. The number of lesions detected by different methods was calculated and compared. The patients were randomly divided into 3 groups based on the different contrast injection rate： 1 ml/s, 2 ml/s and 3 ml/s. The irnags of each group were graded and compared. Results： Of the cases, 18 （ 13.8% ） did not show any abnormal arteries and 112 （86.2%） showed 288 abnormal segments of the arteries. Among all the lesions, atherosclerosing plaque accounted for 34.0% （ n = 98） ; arterial stenosis, 26.0% （ n = 75） ; arterial occlusion, 6.9% （ n = 20） ; tenuous arteries, 15.3% （ n = 44） ; tortuous arteries, 16.0% （ n = 46） ; abberant arteries, 1.4% （ n = 4） ; and aneurysm, 0.3%（n = 1）. For the 93 cases that took both 3D CEMRA and TOF MRA, there was a significant difference between the two methods, except for the external carotid artery. For the 81 cases that took both 3D CEMRA and PC MRA, there was also a significant difference between them for every segment of arteries. For the 8 cases that took both 3D CEMRA and DSA, there was not a significant difference between them. For the three groups divided based on the different contrast injection rate, there was a statistical difference between the group of 1 mils and 3 mils and between the groups of 1 mils and 2 ml/s, but not a significant difference between the groups of 3 mils and 2 mils. Conclusion： 3D CEMRA is a reliable method in the diagnosis of arterial diseases in the neck and can mostly replace the gold standard of DSA.

关 键 词：颈动脉疾病 磁共振血管造影术 对比剂 

分 类 号：R543.5[医药卫生—心血管疾病] R445.2[医药卫生—内科学]